TY - JOUR
T1 - Body Mass Index and Kidney Disease-Related Mortality in Midlife
T2 - A Nationwide Cohort of 2.3 Million Adolescents
AU - Twig, Gilad
AU - Vivante, Asaf
AU - Bader, Tarif
AU - Derazne, Estela
AU - Tsur, Avishai M.
AU - Levi, Moran
AU - Goldberger, Nehama
AU - Leiba, Adi
AU - Kark, Jeremy D.
N1 - Publisher Copyright:
© 2018 The Obesity Society
PY - 2018/4
Y1 - 2018/4
N2 - Objective: This study aimed to evaluate the association of body mass index (BMI) in adolescence with mortality attributed to kidney disease. Methods: In this study, 2,294,139 Jewish Israeli adolescents with measured weight and height at 17 years old during the military fitness assessment were analyzed with a follow-up extending up to 45 years. All kidney-related outcomes, coded by the Central Bureau of Statistics from death notifications as the underlying cause of death, were obtained by linkage. Cox hazards models were applied. Results: During 42,297,007 person-years of follow-up (median 18.4 years), 226 deaths related to kidney disease were recorded. There was an increased risk for kidney-related death among adolescents with overweight and obesity with adjusted hazard ratios of 2.7 (95% CI: 1.8-3.9) and 8.4 (5.1-13.8), respectively, with BMI between 18.5 and 22.0 kg/m2 as the reference. A 15% increased risk for kidney-related mortality (1.11-1.19) per unit increment in BMI was observed. Furthermore, a multivariable spline model indicated a minimum risk for kidney-related mortality starting at BMI of 18.6 kg/m2 with significantly increased risk seen above values of 22.8 kg/m2. The results withstood extensive sensitivity analyses, including stratification of kidney-related death attributed to acute, chronic, and total kidney disease. Conclusions: Adolescent overweight and obesity are risk markers for kidney-related mortality over 4 decades.
AB - Objective: This study aimed to evaluate the association of body mass index (BMI) in adolescence with mortality attributed to kidney disease. Methods: In this study, 2,294,139 Jewish Israeli adolescents with measured weight and height at 17 years old during the military fitness assessment were analyzed with a follow-up extending up to 45 years. All kidney-related outcomes, coded by the Central Bureau of Statistics from death notifications as the underlying cause of death, were obtained by linkage. Cox hazards models were applied. Results: During 42,297,007 person-years of follow-up (median 18.4 years), 226 deaths related to kidney disease were recorded. There was an increased risk for kidney-related death among adolescents with overweight and obesity with adjusted hazard ratios of 2.7 (95% CI: 1.8-3.9) and 8.4 (5.1-13.8), respectively, with BMI between 18.5 and 22.0 kg/m2 as the reference. A 15% increased risk for kidney-related mortality (1.11-1.19) per unit increment in BMI was observed. Furthermore, a multivariable spline model indicated a minimum risk for kidney-related mortality starting at BMI of 18.6 kg/m2 with significantly increased risk seen above values of 22.8 kg/m2. The results withstood extensive sensitivity analyses, including stratification of kidney-related death attributed to acute, chronic, and total kidney disease. Conclusions: Adolescent overweight and obesity are risk markers for kidney-related mortality over 4 decades.
UR - http://www.scopus.com/inward/record.url?scp=85042582790&partnerID=8YFLogxK
U2 - 10.1002/oby.22144
DO - 10.1002/oby.22144
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C2 - 29498231
AN - SCOPUS:85042582790
SN - 1930-7381
VL - 26
SP - 776
EP - 781
JO - Obesity
JF - Obesity
IS - 4
ER -
